Comparison of inflammatory indices in patients with metastatic non-small cell lung cancer

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OBJECTIVE: The aim of this study was to compare the prognostic value of inflammatory indices, including the prognostic nutritional index, advanced lung cancer inflammation index, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, Glasgow Prognostic Score, and C-reactive protein/albumin ratio, in patients with metastatic non-small cell lung cancer and to determine whether any of the indices are correlated. METHODS: The demographic, clinicopathological, and laboratory data of 179 patients with metastatic non-small cell lung cancer who presented to our medical oncology clinic between 2014 and 2021 were retrospectively obtained from the hospital database system. RESULTS: Among the inflammatory indices, C-reactive protein/albumin ratio (p=0.002), advanced lung cancer inflammation index (p=0.04), and neutrophil/lymphocyte ratio (p=0.008) were associated with overall survival. Multivariate overall survival analysis showed that Eastern Cooperative Oncology Group Performance Status score (HR 1.37; 95%CI 1.06-1.77; p=0.016) and C-reactive protein/albumin ratio (HR 1.13; 95%CI 1.03-1.24; p=0.01) were independent prognostic factors associated with overall survival. Patients with a high and low C-reactive protein/albumin ratio differed statistically significantly in terms of gender, histopathological subtype, history of smoking, and metastatic site (p<0.05). Correlation analysis showed that C-reactive protein/albumin ratio was negatively correlated with advanced lung cancer inflammation index (r=-0.433, p<0.001) and positively correlated with the other four indices (neutrophil/lymphocyte ratio: r=0.368, p<0.001; platelet/lymphocyte ratio: r=0.321, p<0.001; Glasgow Prognostic Score: r=0.537, p<0.001; and prognostic nutritional index: r=0.223, p=0.003). CONCLUSION: Our findings show that among the investigated inflammatory indices, C-reactive protein/albumin ratio has the highest prognostic value in patients with metastatic non-small cell lung cancer.

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